Mere Healers: What Medical Training is For and Why it Matters
Farr Curlin, MD, Duke University, Durham, NC
Several years ago, Don Berwick, who had served as director of the Center for Medicaid and Medicare Services, told graduates of Harvard Medical School that they must do more than merely treat those who are sick. They must also seek to cure the injustice that lead to illness. They must fight against poverty, for a stronger social safety net, and for policies that regard health care as a human right. Berwick’s speech struck a chord—reflecting a widespread sense that medical educators must prepare students not only to, in Berwick’s terms, “bring the benefits of biomedical science” to bear, but also to contend for a more just political order. In ensuing years, the list of things that medical students ‘must’ learn and do has grown to include fighting climate change, fighting racism, and more. It is not enough, it seems, for physicians to merely attend to those who are sick.
In this essay, I argue that these moral movements in medicine, while commendable in many respects, both are symptoms of and paradoxically contribute to the deeper problem to which they respond: namely, the de-moralization of medicine itself. To escape this cycle of de-moralization, I will propose, medical educators will need to return to a more modest vision for medicine, in which medical education has succeeded if it trains mere healers—practitioners who reliably attend to those who are sick, in all of their human complexity, and skillfully and conscientiously seek to preserve and restore their health. That healing work is not everything, but it is good, indeed good enough to motivate and inspire physicians throughout their careers.
I will also argue that this modest aim for aspiring physicians reflects a general posture of the Church toward medicine—seeing medicine as a noble but humble art, one that brings good but is also prone to hubris and can get in the way of Christians learning to live with the gifts and the limits of the body. The impulse to have medical practitioners do more appears on the surface to be motivated by concern to genuinely help and to right the injustice of the world. I will argue, however, that the impulse represents both offense at, and insecurity in the face of, our limited capacities to heal, and also a kind of pride that refuses to accept those gifts and limits, presumes an authority it does not have, and seeks vainly to amend what it cannot amend. In the end, medical educators should help medical students see that to be a good physician, it is enough to learn to skillfully and steadfastly attend to those who are sick and injured, seeking to preserve and restore their health.
In this essay, I argue that these moral movements in medicine, while commendable in many respects, both are symptoms of and paradoxically contribute to the deeper problem to which they respond: namely, the de-moralization of medicine itself. To escape this cycle of de-moralization, I will propose, medical educators will need to return to a more modest vision for medicine, in which medical education has succeeded if it trains mere healers—practitioners who reliably attend to those who are sick, in all of their human complexity, and skillfully and conscientiously seek to preserve and restore their health. That healing work is not everything, but it is good, indeed good enough to motivate and inspire physicians throughout their careers.
I will also argue that this modest aim for aspiring physicians reflects a general posture of the Church toward medicine—seeing medicine as a noble but humble art, one that brings good but is also prone to hubris and can get in the way of Christians learning to live with the gifts and the limits of the body. The impulse to have medical practitioners do more appears on the surface to be motivated by concern to genuinely help and to right the injustice of the world. I will argue, however, that the impulse represents both offense at, and insecurity in the face of, our limited capacities to heal, and also a kind of pride that refuses to accept those gifts and limits, presumes an authority it does not have, and seeks vainly to amend what it cannot amend. In the end, medical educators should help medical students see that to be a good physician, it is enough to learn to skillfully and steadfastly attend to those who are sick and injured, seeking to preserve and restore their health.